Usefulness of Apfel score to predict postoperative nausea and vomiting – single-center experiences
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Studenckie Koło Naukowe przy Katedrze Anestezjologii i Intensywnej Terapii, Wydział Lekarski w Katowicach, Śląski Uniwersytet Medyczny w Katowicach
Katedra i Klinika Anestezjologii i Intensywnej Terapii, Wydział Lekarski w Katowicach, Śląski Uniwersytet Medyczny w Katowicach
Łukasz Jerzy Krzych   

Katedra i Klinika Anestezjologii i Intensywnej Terapii, Śląski Uniwersytet Medyczny w Katowicach, ul. Medyków 14, 40-752 Katowice
Ann. Acad. Med. Siles. 2018;72:224–229
Postoperative nausea and vomiting (PONV) are uncomfortable for patients, can prolong hospitalization and can lead to more serious complications, including inadequate pain control or respiratory failure. Accurately predicting which patients are at risk of PONV can help physicians decide when to recommend prophylactic antiemetics. The aim of the study was verify whether the Apfel score is useful in predicting postoperative nausea and vomiting.

Material and methods:
A prospective observation was performed in a group of 101 patients (54F; median age 64y; 51 ASA3+) who underwent surgery between 01.2017 and 03.2017 in a high-volume university hospital. Demographic and clinical data was recorded and the Apfel score was calculated. For the final result, the occurrence of PONV on the first day after surgery was accepted.

The mean time of anesthesia was 216 ± 121 min. Most patients (n = 86) underwent gastro-intestinal surgery. Antiemetic prophylaxis was given to 68 persons. The median Apfel score was 2 (IQR 2–3). An Apfel score of 4 pts was found in 14 subjects. Postoperative nausea and vomiting occurred in 9 patients. Although none of the individual components of the Apfel scale predicted PONV in bivariate comparisons, the total score was useful in predicting PONV (AUC = 0.734; 95% CI 0.636–0.817; p < 0.01). Antiemetic treatment resulted in a 65% reduction in the occurrence of PONV (OR = 0.35; 95% CI 0.08–1.4; p = 0.1).

Although the Apfel score helps recognize patients at risk of PONV, identifying patients who should receive prophylactic antiemetics needs further investigation.

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